Évaluation de l'équilibre et de la marche en consultation ou HdJ mémoire
Pour en savoir plus
L’association entre troubles cognitifs et troubles de la marche est connue de longue date, et pas seulement liée à leur prévalence respective dans la population âgée (1). Cependant, le mécanisme physiopathologique sous-jacent n’en est pas complètement élucidé.
Comme l’évaluation mnésique, l’évaluation de la marche et du risque de chute a fait l’objet d’une littérature abondante pour mettre en place des critères objectifs d’appréciation (2). Certains sont très simples d’utilisation, comme c’est le cas de la vitesse de marche ou le 10meters walking test. D’autres nécessitent un examen plus poussé. C’est le cas de la Short Physical Perfomance Battery (SPPB) qui additionne des critères d’équilibre, vitesse de marche et transfert assis/debout (3); et plus encore du test de Tinetti (4) qui comprend 22 items dans sa version originale.
Nombre d’entre eux ont ainsi montré une corrélation avec un déclin cognitif (5). Les tests en double-tâche ont aussi montré leur intérêt pour mieux évaluer l’association entre cognition et risque de chute (5), comme c’est le cas du test “Stop walking when talking” (6).
Pour aller plus loin, des examens complémentaires ont également montré leur intérêt dans l’évaluation de la marche (7).
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(1) Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England journal of medicine, 319(26), 1701-1707.
(2) Park, S. H. (2018). Tools for assessing fall risk in the elderly: a systematic review and meta-analysis.
Aging clinical and experimental research, 1-16.
(3) Vasunilashorn, S., Coppin, A. K., Patel, K. V., Lauretani, F., Ferrucci, L., Bandinelli, S., & Guralnik, J. M. (2009). Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64(2), 223-229.
(4) Raîche, M., Hébert, R., Prince, F., & Corriveau, H. (2000). Screening older adults at risk of falling with the Tinetti balance scale. The Lancet, 356(9234), 1001-1002.
(5) Montero-Odasso, M., Verghese, J., Beauchet, O., & Hausdorff, J. M. (2012). Gait and cognition: a complementary approach to understanding brain function and the risk of falling. Journal of the American Geriatrics Society, 60(11), 2127-2136.
(6) Lundin-Olsson, L., Nyberg, L., & Gustafson, Y. (1997). Stops walking when talking as a predictor of falls in elderly people. Lancet, 349(9052), 617
(7) Sterke, C. S., van Beeck, E. F., Looman, C. W., Kressig, R. W., & van der Cammen, T. J. (2012). An electronic walkway can predict short-term fall risk in nursing home residents with dementia. Gait & posture, 36(1), 95-101.
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